Little D N, Hammond C, Kollisch D, Stern B, Gagne R, Dietrich A J
Department of Family Practice, University of Vermont College of Medicine, Burlington 05405-0068, USA.
J Fam Pract. 1998 Nov;47(5):375-7.
Communication between primary care physicians (PCPs) and mental health providers (MHPs) is integral to the management of depressive disorders. Our study investigated referrals from PCPs to MHPs in a rural research network.
From April 1997 to September 1997, 5 family physicians tracked 6 weeks of referrals for depression and non-mental health problems and assessed the outcomes of these referrals after 3 months. The referrals were characterized by the nature and extent of communication between the PCP and the MHP and by the effectiveness of the consultation.
Sixty-seven patients (44 with non-mental health disorders and 23 with depressive disorders) were identified and followed. Analysis of the initial referral process showed that the referring physicians felt a greater sense of urgency for the referrals for depression. Written evidence of the referral in the patient's chart at the 3-month survey was more common for non-mental health disorders.
This pilot study demonstrates that there are communication barriers between PCPs and their mental health colleagues. Enhanced communication might improve satisfaction with the referral process. The details of the referral process need further study.
基层医疗医生（PCP）与心理健康服务提供者（MHP）之间的沟通对于抑郁症的管理至关重要。我们的研究调查了农村研究网络中基层医疗医生向心理健康服务提供者的转诊情况。
1997年4月至1997年9月，5名家庭医生追踪了6周内因抑郁症和非心理健康问题的转诊情况，并在3个月后评估了这些转诊的结果。转诊的特征包括基层医疗医生与心理健康服务提供者之间沟通的性质和程度以及咨询的效果。
共识别并跟踪了67名患者（44名患有非心理健康障碍，23名患有抑郁症）。对初始转诊过程的分析表明，转诊医生对抑郁症转诊的紧迫感更强。在3个月的调查中，患者病历中有转诊书面证据的情况在非心理健康障碍患者中更为常见。
这项试点研究表明，基层医疗医生与其心理健康同事之间存在沟通障碍。加强沟通可能会提高对转诊过程的满意度。转诊过程的细节需要进一步研究。
